Sciatica

Sciatica refers to pain, weakness, numbness or tingling in the leg. It is not a medical condition on its own, but rather the result of another medical problem.

Sciatica — often referred to as a pinched nerve — occurs when the sciatic nerve is damaged or put under pressure. Nerve roots in the lower spine become the sciatic nerve which runs down the back of each leg. The sciatic nerve controls the muscles of the back of the knee and lower leg. It also provides sensation to the back of the thigh, part of the lower leg and the sole of the foot.

Sciatica generally improves over the course of several weeks. In about 50 percent of cases it may come back for a time as the condition improves. Acute pain lasting more than six weeks is one of the red flags of back pain, and requires prompt attention.

By far, the most common cause of sciatica a herniated disc. Sciatica can also result from spinal stenosis, Piriformis syndrome (which involves compression in the buttock muscles), spinal tumors and pelvic injuries or fractures.

You may hear the word "radiculopathy" in relation to sciatica. Radiculopathy is a more general term that includes any condition affecting the spinal nerves, although the terms are often used interchangeably.

Symptoms

Sciatica pain usually occurs on one side of the body and can be felt in the leg, hips, back of the knee, calf or sole of the foot.

Sensations can include:

Mild tingling

Sharp pain

Weakness

Dull ache

Burning sensation

Numbness

Pain often starts slowly, and may get worse at different times of day or after standing or sitting for long periods. In some cases, people are unable to move because the pain is so severe.

Alleviating Sciatica Pain

Because sciatica is the result of another medical condition, treatment focuses on that condition, whether a herniated disc, spinal stenosis or something else.

Helpful steps to calm symptoms and reduce inflammation include:

Applying heat or ice to the painful area. (Try ice for the first 48 to 72 hours, then use heat.)

Taking over-the-counter pain relievers such as ibuprofen or acetaminophen.

Reducing your activities when the pain first occurs. (Bed rest is not recommended because studies have shown that more than a day or two of bed rest results in poorer outcomes.)

Avoiding prolonged sitting or lying with pressure on the buttocks.

Physical therapy may be recommended if pain makes it difficult to resume normal movement.

In cases where sciatica fails to improve, specialized medical or surgical treatment may be recommended. Advanced imaging such as MRI scans can be used to identify the cause of sciatica in unusual cases or if surgical or interventional treatment is planned. In more typical cases it is often not needed.

For more information about sciatica you can contact the Spine Center at Virginia Mason by calling (206) 417-7463.